Younger age at onset and sex predict celiac disease in children and adolescents with type 1 diabetes: an Italian multicenter study

OBJECTIVE— To estimate the prevalence of biopsy-confirmed celiac disease in Italian children and adolescents with type 1 diabetes and to assess whether age at onset of type 1 diabetes is independently associated with diagnosis of celiac disease. RESEARCH DESIGNANDMETHODS— The study group was a clinic-based cohort of children and adolescents with type 1 diabetes cared for in 25 Italian centers for childhood diabetes. Yearly screening for celiac disease was performed using IgA/IgG anti-gliadin and IgA anti-endomysium antibodies. RESULTS— Of the 4,322 children and adolescents (age 11.8 4.2 years) identified with type 1 diabetes, biopsy-confirmed celiac disease was diagnosed in 292 (prevalence 6.8%, 95% confidence interval [CI] 6.0 –7.6), with a higher risk seen in girls than in boys (odds ratio [OR] 1.93, 1.51–2.47). In 89% of these, diabetes was diagnosed before celiac disease. In logistic regression analyses, being younger at onset of diabetes, being female, and having a diagnosis of a thyroid disorder were independently associated with the risk of having diabetes and celiac disease. In comparison with subjects who were older than 9 years at onset of diabetes, subjects who were younger than 4 years at onset had an OR of 3.27 (2.20–4.85). CONCLUSIONS— We have provided evidence that 1) the prevalence of biopsy-confirmed celiac disease in children and adolescents with type 1 diabetes is high (6.8%); 2) the risk of having both diseases is threefold higher in children diagnosed with type 1 diabetes at age 4 years than in those age 9 years; and 3) girls have a higher risk of having both diseases than boys

Neurobiologia da aprendizagem escolar

O conhecimento sobre Neurobiologia cresce exponencialmente no meio científico, abordando temas como atenção, memória e aprendizagem que possuem interface com a Educação. Contudo, a contribuição desses conhecimentos para a realidade da sala de aula é dificultada pelo afastamento entre as áreas, considerando seus métodos, objetivos e linguagem distintos. A informação veiculada de forma apressada e descompromissada sobre o cérebro humano, nos meios jornalísticos de divulgação científica, tem gerado mitos e equívocos amplamente difundidos na sociedade, bem como entre os professores. Nesta ação, realizada durante os anos de 2011 e 2012, tivemos por objetivos avaliar o conhecimento dos professores das escolas de ensino básico de Botucatu - SP, sobre Neurobiologia da Aprendizagem, e proporcionar espaços de discussão para a atualização na área. Foram realizadas entrevistas e aplicados questionários, os quais constituíram ferramentas para contextualizar e avaliar os conhecimentos já solidificados, visando à criação de espaços para diálogo e reflexão sobre o tema. A aproximação entre profissionais da Universidade e da Educação Básica foi uma experiência enriquecedora e importante para minimizar as distorções conceituais em Neurobiologia e para contribuir com a formação continuada dos educadores, de ambos os setores

Perceptual and multiparametric analysis of the voice in GERD patients

Not availabl

Optimal treatment of laryngopharyngeal reflux disease

Laryngopharyngeal reflux is defined as the reflux of gastric content into larynx and pharynx. A large number of data suggest the growing prevalence of laryngopharyngeal symptoms in patients with gastroesophageal reflux disease. However, laryngopharyngeal reflux is a multifactorial syndrome and gastroesophageal reflux disease is not the only cause involved in its pathogenesis. Current critical issues in diagnosing laryngopharyngeal reflux are many nonspecific laryngeal symptoms and signs, and poor sensitivity and specificity of all currently available diagnostic tests. Although it is a pragmatic clinical strategy to start with empiric trials of proton pump inhibitors, many patients with suspected laryngopharyngeal reflux have persistent symptoms despite maximal acid suppression therapy. Overall, there are scant conflicting results to assess the effect of reflux treatments (including dietary and lifestyle modification, medical treatment, antireflux surgery) on laryngopharyngeal reflux. The present review is aimed at critically discussing the current treatment options in patients with laryngopharyngeal reflux, and provides a perspective on the development of new therapies

Diabetes incidence in 0- to 14-year age-group in Italy: a 10-year prospective study.

OBJECTIVE: The Registry for Type 1 Diabetes Mellitus in Italy (RIDI) Study Group was established to coordinate the registries of type 1 diabetes in Italy. This report is based on 3,606 children younger than 15 years diagnosed with type 1 diabetes and prospectively registered during 1990-1999 by nine centers, covering >35% of the Italian population. RESEARCH DESIGN AND METHODS: Registries were pooled in four geographic macro-areas: north, central, south, and insular. The completeness of registration was assessed by the capture-recapture method. Poisson regression analysis was used to evaluate temporal trend in incidence. RESULTS: Large variations in incidence were confirmed not only between Sardegna and the mainland but also among peninsular areas. In Sardegna, there was an excess of boys (the boy-to-girl incidence ratio was 1.4). The overall incidence showed average increases of 3.6% (P <0.001) and 3.7% (P <0.001) per year in peninsular Italy and in Sardegna, respectively. Significant increases in incidence rates were found in boys aged 10-14 years (6.7%, 95% CI 0.5-13.3) and in girls aged 5-9 years (6.6%, 0.5-13.1) living in the southern area. The incidence rate also increased in boys aged 10-14 years (5.0%, 0.3-10) and in girls aged 0-4 years (4.9%, 0.8-9.1) living in Sardegna. CONCLUSIONS: Italy is a country with large geographical variations in incidence rates of type 1 diabetes. However, the rates are evenly increasing both in the mainland and Sardegna, suggesting that similar environmental factors are operating over populations that have different genetic backgrounds

Thymic IGF-2 and central self-tolerance of the insulin family: a basis for the development of a negative vaccine against type 1 diabetes

BACKGROUND AND AIMS: Diabetic nephropathy is a leading cause of end-stage renal disease. The aldose reductase (AR) gene, which codes for the first and rate-limiting enzyme in the polyol pathway, has been implicated in the etiology of diabetic nephropathy, based on genetic association studies and findings from animals treated with AR inhibitors. However, the exact role of AR in the development of diabetic nephropathy and its interaction with other pathogenetic pathways, such as non-enzymatic glycation, remain controversial. In this study, we investigated the effects of increased AR gene expression on pathogenetic changes that could lead to diabetic nephropathy, in a transgenic murine model. MATERIALS AND METHODS: Transgenic mouse lines expressing the human AR (hAR) gene in kidney mesangial cells were established, using a construct that contained the type A scavenger receptor promoter. The interaction between AR and advanced glycation end-products (AGEs) was examined in primary cultures of mesangial cells derived from hAR transgenic and wild type mice, with regard to changes in AR activity, transforming growth factor-β1 (TGF-β1) and type IV collagen gene expression, in response to incubation with AGE modified BSA (AGEBSA). RESULTS: hAR mRNA expression could be detected by Northern blot analysis in the kidney glomeruli of transgenic mice. hAR mRNA and protein expression were also found in primary cultures of transgenic mesangial cells, as assessed by RT-PCR and Western blot analyses. Enhanced AR activity was seen in both transgenic and wild type mesangial cells when treated with AGE-BSA. This increase was significantly higher (p<0.05) in the transgenic mesangial cells. The rise in AR activity in the presence of AGE-BSA was accompanied by increases in TGF-β1 and type IV collagen transcripts in mesangial cells, which reached statistical significance only in transgenic mesangial cells (p<0.01) and was abolished by the addition of an AR inhibitor zopolrestat (p<0.05). CONCLUSION: These results suggested that the AR gene was involved in the increased expression of TGF-β1 and type IV collagen observed in the transgenic mesangial cells in vitro. Increased AR gene expression might contribute to the mesangial cell proliferation and matrix protein production in diabetic nephropathy, in part through an interaction with AGEs. Supported by a grant from the Hong Kong Research Grant Council (HKU7270/98M).link_to_OA_fulltextThe 18th International Diabetes Federation Congress (IDF), Paris, France, 24-29 August 2003. In Diabetologia, 2003, v. 46 n. 2 suppl., p. A342, abstract no. 99

Suspected laryngopharyngeal reflux evaluated with multichannel impedance and Ph-monitoring. How many are gerd patients?

No abstract availabl